|
|
|
Maintaining Healthy Cholesterol Profiles with Niacin |
|
|
|
by Carol Waslien, Ph.D. and Dan Murray
Therapeutic Supplementation for Cholesterol
When discussing vitamins, the
topic of therapeutic nutritional
supplementation is no more
clearly demonstrated than in the case of
vitamin B3 in the form of niacin. In food fortification,
the levels of vitamin B3 are barely
enough to avoid clinical signs of deficiency.
In multivitamins, the niacin and niacinamide
levels are designed to supplement a
normal, if not healthy, diet. However, in levels that are 10 to 20 times typical multivitamin
levels, niacin has well substantiated
benefits for maintaining healthy cholesterol
levels.
Vitamin B3 Sources
Niacin and niacinamide are both referred to
as vitamin B3. They commonly appear on
food ingredient or vitamin supplement
labels and play an important role in protein,
energy and fat metabolism. Traditionally
niacin is used to enrich food products such
as milled flour, rice and cereal. Niacinamide
is more often used in supplements and multivitamins.
As food and dietary supplement
ingredients these two are interchangeable
and both are considered safe and efficacious.
In a therapeutic nutritional supplementation
role only niacin helps to maintain healthy
blood cholesterol profiles.
In multivitamin supplements niacin is
efficiently absorbed at levels of 30–100
mg/day. It can also be absorbed at pharmacological
levels of 1–2 grams/day. At these higher levels, niacin will elevate liver enzyme
profiles but usually not outside a normal
range. Unlike the fat soluble vitamins A, D, E
and K, niacin is not stored, so toxicity from
supplementation is rare.
Cholesterol Concerns and Niacin
How can this common food/supplement
ingredient consumed daily be good for the
heart? The 40-year plus Framingham Heart
Study long ago established the relationship
between heart health, niacin and a person’s
blood lipid profile, a key indicator of cardiovascular
health.
Blood lipid profiles are often summarized
by the total cholesterol (TC) which is made
up of cholesterol attached to LDL (low-density
lipoprotein) and to HDL (high-density
lipoprotein). Researchers have determined
that excess amounts of LDL, or “bad cholesterol,”
cling to the walls of arteries. Over
time, a build up of these deposits, called
plaque, will narrow the arteries and restrict
blood flow to the heart. Heart disease and
heart attacks are often a result of the
restricted blood flow caused by the plaque.
HDL is considered “good cholesterol”
because it reverses the action of LDL by
removing the plaque.
After diet and exercise, experts consider
niacin the first line of defense in addressing
unhealthy cholesterol. Niacin is unique in
that it plays the dual role of reducing LDL
and increasing HDL. In numerous human
studies niacin has consistently shown
increases in HDL by up to 45 percent and
decreases in LDL by as much as 54 percent.
Niacin is safe and even complementary
when used with statin drugs. Niacinamide, the alternative source of vitamin B3, offers no
benefit in cholesterol management. There
are several theories on niacin’s mode of action
but no firm conclusions.
|
After diet and exercise, experts consider niacin the
first
line of defense in addressing unhealthy cholesterol. |
|
|
Flushing from Niacin
Flushing is an annoying side effect of niacin.
Flushing is the physical sensation of warmth,
tingling and redness of the skin and is a
direct result of increased blood circulation. It
is common when first starting supplementation
but often subsides with regular use. A person starting on 500 mg to 1 gram of plain
niacin per day (not time-release niacin) may
experience this sensation for the first seven to
10 days of supplementation. Flushing is not
harmful and passes in 20 or 30 minutes but
when unexpected, the reaction can be
alarming.
To reduce the likelihood of flushing, it is
wise to take niacin with meals and not on an
empty stomach. Avoid taking niacin with
alcohol or hot beverages as it may increase
blood circulation. Many people take one
adult aspirin (325 mg) or one baby aspirin
(81 mg) each day prior to taking niacin,
which may reduce the incidence of flushing.
Since flushing is unique to the individual,
some people are affected more than others.
 Sustained Release Niacin
Supplement manufacturers have developed
special technologies to help reduce the incidence
of flushing associated with plain
niacin. These products are referred to as “sustained
release” or “time released” niacin.
These products slow the body’s absorption of
niacin and reduce the incidence of flushing.
If flushing bothers you, these products offer
an excellent solution.
Beware. Some products are promoted or
labeled as “no-flush niacin” but are really
niacin-like compounds. These supplements
may have nutritional value or improve circulation
but they have not been tested exhaustively
in humans like niacin has for its
cholesterol benefit. The ingredient section
on supplement packaging will indicate the
source of the raw ingredient. Make sure the
label states niacin or nicotinic acid.
Summary
As a dietary supplement, niacin plays an
important role in protein, carbohydrate and
fat metabolism. It is important enough to
our health and well-being that we routinely
fortify food with niacin and often still fall
short of optimum levels.
When considering therapeutic nutritional
supplementation, niacin is safe, inexpensive
and effective at maintaining healthy cholesterol
levels. Consider consulting with a health
care professional to learn how niacin may
help improve your blood lipid profiles. TH
References available upon request. Send a SASE to totalhealth.
|
|
|
